Cardiac resynchronization therapy non-responder to responder conversion rate in the more response to cardiac resynchronization therapy with MultiPoint Pacing (MORE-CRT MPP) study: results from Phase I.
- Leclercq C Université de Rennes I, CICIT 804, Rennes, CHU Pontchaillou, Rennes, France.
- Burri H University of Geneva, Geneva, Switzerland.
- Curnis A Università degli Studi di Brescia, Brescia, Italy.
- Delnoy PP Isala Klinieken, Zwolle, The Netherlands.
- Rinaldi CA King's College, London, UK.
- Sperzel J Kerckhoff Klinik, Bad Nauheim, Germany.
- Lee K Abbott, Plano, TX, USA.
- Calò L Policlinico Casilino, Italy.
- Vicentini A Casa di Cura Dott, Pederzoli, Italy.
- Concha JF Hospital Universitario Infanta Cristina, Spain.
- Thibault B Université de Montréal, Montreal, Canada.
- 2019-03-13
Published in:
- European heart journal. - 2019
Biventricular pacing
Cardiac resynchronization
Heart failure
MPP
MultiPoint Pacing
Quadripolar left ventricular pacing
Randomized controlled study
Aged
Aged, 80 and over
Cardiac Pacing, Artificial
Cardiac Resynchronization Therapy
Cardiac Resynchronization Therapy Devices
Double-Blind Method
Echocardiography
Electrocardiography
Female
Follow-Up Studies
Heart Failure
Hemodynamics
Humans
Male
Middle Aged
Prospective Studies
Surveys and Questionnaires
Treatment Outcome
English
AIMS
To assess the impact of MultiPoint™ Pacing (MPP)-programmed according to the physician's discretion-in non-responders to standard biventricular pacing after 6 months.
METHODS AND RESULTS
The study enrolled 1921 patients receiving a quadripolar cardiac resynchronization therapy (CRT) system capable of MPP™ therapy. A core laboratory assessed echocardiography at baseline and 6 months and defined volumetric non-response to biventricular pacing as <15% reduction in left ventricular end-systolic volume (LVESV). Clinical sites randomized patients classified as non-responders in a 1:1 ratio to receive MPP (236 patients) or continued biventricular pacing (231 patients) for an additional 6 months and evaluated rate of conversion to echocardiographic response. Baseline characteristics of both groups were comparable. No difference was observed in non-responder to responder conversion rate between MPP and biventricular pacing (31.8% and 33.8%, P = 0.72). In the MPP arm, 68 (29%) patients received MPP programmed with a wide LV electrode anatomical separation (≥30 mm) and shortest LV1-LV2 and LV2-RV timing delays (MPP-AS); 168 (71%) patients received MPP programmed with other settings (MPP-Other). MPP-AS elicited a significantly higher non-responder conversion rate compared to MPP-Other (45.6% vs. 26.2%, P = 0.006) and a trend in a higher conversion rate compared to biventricular pacing (45.6% vs. 33.8%, P = 0.10).
CONCLUSIONS
After 6 months, investigator-discretionary MPP programming did not significantly increase echocardiographic response compared to biventricular pacing in CRT non-responders.
To assess the impact of MultiPoint™ Pacing (MPP)-programmed according to the physician's discretion-in non-responders to standard biventricular pacing after 6 months.
METHODS AND RESULTS
The study enrolled 1921 patients receiving a quadripolar cardiac resynchronization therapy (CRT) system capable of MPP™ therapy. A core laboratory assessed echocardiography at baseline and 6 months and defined volumetric non-response to biventricular pacing as <15% reduction in left ventricular end-systolic volume (LVESV). Clinical sites randomized patients classified as non-responders in a 1:1 ratio to receive MPP (236 patients) or continued biventricular pacing (231 patients) for an additional 6 months and evaluated rate of conversion to echocardiographic response. Baseline characteristics of both groups were comparable. No difference was observed in non-responder to responder conversion rate between MPP and biventricular pacing (31.8% and 33.8%, P = 0.72). In the MPP arm, 68 (29%) patients received MPP programmed with a wide LV electrode anatomical separation (≥30 mm) and shortest LV1-LV2 and LV2-RV timing delays (MPP-AS); 168 (71%) patients received MPP programmed with other settings (MPP-Other). MPP-AS elicited a significantly higher non-responder conversion rate compared to MPP-Other (45.6% vs. 26.2%, P = 0.006) and a trend in a higher conversion rate compared to biventricular pacing (45.6% vs. 33.8%, P = 0.10).
CONCLUSIONS
After 6 months, investigator-discretionary MPP programming did not significantly increase echocardiographic response compared to biventricular pacing in CRT non-responders.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1093/eurheartj/ehz109
- PMID 30859220
- Persistent URL
- https://sonar.ch/global/documents/252730
Statistics
Document views: 25
File downloads:
- fulltext.pdf: 0